Cancer

Cancer

a malign

ant neoplasm,

group

of

known

medically
a

broad

various diseases,
involving

growth.

is

as

In

all

unregulated

cell

cancer, cells divide

and

grow

uncontrollably,

forming

malignant

tumors,

invade

and

nearby parts of the body.

The

cancer

may

also spre

ad to more distant parts

of

body

the

the lymp

through

hatic

system or

bloodstream.
tumors

are

Not

all

cancerous. Benign

tumors do not grow uncontrollably, do not invade neighboring tissues, and do not spread
throughout the body. There are over 200 different known cancers that afflict humans. [1]
Determining what causes cancer is complex. Many things are known to increase the risk of
cancer,

including tobacco use,

certain infections, radiation, activity,

obesity,

and

environmental pollutants.[2] These can directly damage genes or combine with existing
genetic faults within cells to cause the disease. [3] Approximately five to ten percent of
cancers are entirely hereditary.
Cancer can be detected in a number of ways, including the presence of certain signs and
symptoms, screening tests, or medical imaging. Once a possible cancer is detected it is
diagnosed by microscopic examination of a tissue sample. Cancer is usually treated with
chemotherapy, radiation therapy and surgery. The chances of surviving the disease vary
greatly by the type and location of the cancer and the extent of disease at the start of

treatment. While cancer can affect people of all ages, and a few types of cancer are more
common in children, the risk of developing cancer generally increases with age. In 2007,
cancer caused about 13% of all human deaths worldwide (7.9 million). Rates are rising as
more people live to an old age and as mass lifestyle changes occur in the developing world

Signs and symptoms

Cancer signs and symptoms

Symptoms of cancer metastasis depend on the location of the tumor.

When cancer begins it invariably produces no symptoms with signs and symptoms only
appearing as the mass continues to grow or ulcerates. The findings that result depends on
the type and location of the cancer. Few symptoms are specific, with many of them also
frequently occurring in individuals who have other conditions. Cancer is the new "great
imitator". Thus it is not uncommon for people diagnosed with cancer to have been treated
for other diseases to which it was assumed their symptoms were due. []

Local effects
Local symptoms may occur due to the mass of the tumor or its ulceration. For example,
mass

effects

from lung

cancer can

cause

blockage

of

the bronchus resulting

in cough orpneumonia; esophageal cancer can cause narrowing of the esophagus, making
it difficult or painful to swallow; and colorectal cancer may lead to narrowing or blockages
in the bowel, resulting in changes in bowel habits. Masses of breast or testicles may be

easily felt.Ulceration can cause bleeding which, if it occurs in the lung, will lead to coughing
up blood, in the bowels to anemia or rectal bleeding, in the bladder to blood in the urine,
and in the uterus to vaginal bleeding. Although localized pain may occur in advanced
cancer, the initial swelling is usually painless. Some cancers can cause build up of fluid
within the chest or abdomen.[5]

Systemic symptoms
General symptoms occur due to distant effects of the cancer that are not related to direct
or metastatic spread. These may include: unintentional weight loss, fever, being
excessively tired, and changes to the skin. [6] Hodgkin disease, leukemias, and cancers of
the liver or kidney can cause a persistent fever of unknown origin.[5]
Specific constellations of systemic symptoms, termed paraneoplastic phenomena, may
occur

with

some

cancers.

Examples

include

the

appearance

of myasthenia

gravis in thymoma and clubbing in lung cancer.]

Causes
Cancers are primarily an environmental disease with 9095% of cases attributed to
environmental factors and 510% due to genetics. [2]Environmental, as used by cancer
researchers, means any cause that is not inherited genetically, not merely pollution.
[7]

Common environmental factors that contribute to cancer death include tobacco (25

30%), diet and obesity (3035%), infections (1520%),radiation (both ionizing and nonionizing, up to 10%), stress, lack of physical activity, and environmental pollutants.[]

Chemicals
Further information: Alcohol and cancer and Smoking and cancer

The incidence of lung cancer is highly correlated with smoking.

Cancer pathogenesis is traceable back to DNA mutations that impact cell growth and
metastasis. Substances that cause DNA mutations are known as mutagens, and mutagens
that cause cancers are known as carcinogens. Particular substances have been linked to
specific types of cancer. Tobacco smoking is associated with many forms of cancer,[] and
causes 90% of lung cancer.[]
Many mutagens are also carcinogens, but some carcinogens are not mutagens. Alcohol is
an example of a chemical carcinogen that is not a mutagen. In Western Europe 10% of
cancers in males and 3% of cancers in females are attributed to alcohol.
Decades of research has demonstrated the link between tobacco use and cancer in
thelung, larynx,
[12]

Tobacco

head,
smoke

neck,

stomach,

contains

bladder,
over

kidney, esophagus and pancreas.

fifty

known

carcinogens,

including nitrosamines and polycyclic aromatic hydrocarbons. Tobacco is responsible for

about one in three of all cancer deaths in the developed world, [] and about one in five
worldwide. Lung cancer death rates in the United States have mirrored smoking patterns,

with increases in smoking followed by dramatic increases in lung cancer death rates and,
more recently, decreases in smoking rates since the 1950s followed by decreases in lung
cancer death rates in men since 1990. However, the numbers of smokers worldwide is still
rising, leading to what some organizations have described as the tobacco epidemic.[]
Cancer related to one's occupation is believed to represent between 220% of all cases.
[17]

Every year, at least 200,000 people die worldwide from cancer related to their

workplace.[18] Most cancer deaths caused by occupational risk factors occur in the
developed world.[18] It is estimated that approximately 20,000 cancer deaths and 40,000
new cases of cancer each year in the U.S. are attributable to occupation. [19] Millions of
workers run the risk of developing cancers such as lung cancer and mesothelioma from
inhaling asbestos fibers and tobacco smoke, or leukemia from exposure to benzene at
their workplaces.

Radiation
Main article: radiation-induced cancer
Up to 10% of invasive cancers are related to radiation exposure, including both ionizing
radiation and non-ionizing radiation.[2]Additionally, the vast majority of non-invasive cancers
are non-melanoma skin cancers caused by non-ionizing ultraviolet radiation.

Sources

of

ionizing

radiation include medical

imaging,
Radiation

and radon gas.

can

cause

cancer in most parts of

the body, in all animals,
and at any age, although
radiation-induced

solid

tumors usually take 10

15 years, and can take up
to 40 years, to become
clinically

manifest,

and

radiation-induced leukemias typically require 210 years to appear.[26] Some people, such
as those with nevoid basal cell carcinoma syndrome or retinoblastoma, are more
susceptible than average to developing cancer from radiation exposure. [26]Children and
adolescents are twice as likely to develop radiation-induced leukemia as adults; radiation
exposure before birth has ten times the effect. [26] Ionizing radiation is not a particularly
strong mutagen.[26] Residential exposure to radon gas, for example, has similar cancer
risks as passive smoking.[26] Low-dose exposures, such as living near a nuclear power
plant, are generally believed to have no or very little effect on cancer development.
[26]

Radiation is a more potent source of cancer when it is combined with other cancer-

causing agents, such as radon gas exposure plus smoking tobacco. [26]

Heredity
Main article: Cancer syndrome
The vast majority of cancers are non-hereditary ("sporadic cancers"). Hereditary
cancers are primarily caused by an inherited genetic defect. Less than 0.3% of the

population are carriers of a genetic mutation which has a large effect on cancer risk and
these cause less than 310% of all cancer.[31] Some of these syndromes include: certain
inherited mutations in the genes BRCA1 and BRCA2 with a more than 75% risk of breast
cancer and ovarian cancer,[31] and hereditary nonpolyposis colorectal cancer (HNPCC or
Lynch syndrome) which is present in about 3% of people with colorectal cancer,[ among
others.

Hormones
Some hormones play a role in the development of cancer by promoting cell proliferation.
[35]

Hormones are important agents in sex-related cancers such as cancer of the

breast, endometrium, prostate, ovary, and testis, and also of thyroid cancer and bone

cancer.
An individual's hormone levels are mostly determined genetically, so this may at least
partly explains the presence of some cancers that run in families that do not seem to have
any cancer-causing genes.[35] For example, the daughters of women who have breast
cancer have significantly higher levels of estrogen and progesterone than the daughters of
women without breast cancer. These higher hormone levels may explain why these women
have higher risk of breast cancer, even in the absence of a breast-cancer gene.

Prevention
Cancer prevention is defined as active measures to decrease the risk of cancer. [45] The
vast majority of cancer cases are due to environmental risk factors, and many, but not all,
of these environmental factors are controllable lifestyle choices. Thus, cancer is considered
a largely preventable disease.[46] Greater than 30% of cancer deaths could be prevented by

avoiding risk factors including: tobacco, overweight / obesity, an insufficient diet, physical
inactivity, alcohol, sexually transmitted infections, and air pollution.[47] Not all environmental
causes are controllable, such as

naturally occurring background radiation, and

other cases of cancer are caused

through hereditary genetic disorders, and thus

it is not possible to prevent

all cases of cancer.

Vaccination
Vaccines have been developed that prevent some infection by some viruses. [66] Human
papillomavirus vaccine (Gardasil and Cervarix) decreases the risk of developing cervical
cancer.[66] The hepatitis B vaccine prevents infection with hepatitis B virus and thus
decreases the risk of liver cancer.[66]
Chemotherapy
Chemotherapy in addition to surgery has proven useful in a number of different cancer
types

including: breast

cancer,

colorectal

cancer,pancreatic

cancer, osteogenic

sarcoma, testicular cancer, ovarian cancer, and certain lung cancers. [88] The effectiveness
of chemotherapy is often limited by toxicity to other tissues in the body.

Systemic symptoms
General symptoms occur due to distant effects of the cancer that are not
related to direct or metastatic spread. These may include: unintentional weight
loss, fever, being excessively tired, and changes to the skin. [6] Hodgkin

disease, leukemias, and cancers of the liver or kidney can cause a

persistent fever of unknown origin.[5]

Diagnosis
Most cancers are initially recognized either because of the appearance of signs
or symptoms or through screening. Neither of these lead to a definitive
diagnosis, which requires the examination of a tissue sample by a pathologist.
People with suspected cancer are investigated with medical tests. These
commonly include blood tests, X-rays, CT scansand endoscopy.

Classification
Cancers are classified by the type of cell that the tumor cells resemble and is
therefore presumed to be the origin of the tumor. These types include:
Carcinoma: Cancers derived from epithelial cells. This group includes many
of the most common cancers, particularly in the aged, and include nearly all
those developing in thebreast, prostate, lung, pancreas, and colon.
Sarcoma:

Cancers

arising

from connective

tissue (i.e. bone, cartilage, fat, nerve), each of which develop from cells
originating in mesenchymal cells outside the bone marrow.
Lymphoma and leukemia: These two classes of cancer arise from
hematopoietic (blood-forming) cells that leave the marrow and tend to

mature in the lymph nodes and blood, respectively. Leukemia is the most
common type of cancer in children accounting for about 30%.[44]
Germ cell tumor: Cancers derived from pluripotent cells, most often
presenting

in

the testicle or

the ovary (seminoma anddysgerminoma,

respectively).
Blastoma: Cancers derived from immature "precursor" cells or embryonic
tissue. Blastomas are more common in children than in older adults.
Cancers are usually named using -carcinoma, -sarcoma or -blastoma as a
suffix, with the Latin or Greek word for the organ or tissue of origin as the root.
For example, cancers of the liver parenchyma arising from malignant epithelial
cells is called hepatocarcinoma, while a malignancy arising from primitive liver
precursor cells is called a hepatoblastoma, and a cancer arising from fat cells is
called aliposarcoma. For some common cancers, the English organ name is
used. For example, the most common type of breast cancer is called ductal
carcinoma of the breast. Here, the adjective ductal refers to the appearance of
the cancer under the microscope, which suggests that it has originated in the
milk ducts.
Benign tumors (which are not cancers) are named using -oma as a suffix with
the organ name as the root. For example, a benign tumor of smooth muscle
cells is called a leiomyoma (the common name of this frequently occurring
benign tumor in the uterus is fibroid). Confusingly, some types of cancer use
the -noma suffix, examples including melanoma and seminoma.

Some types of cancer are named for the size and shape of the cells under a
microscope, such as giant cell carcinoma, spindle cell carcinoma, and small cell
carcinoma.